PATIENT'S BILL OF RIGHTS

Patient Rights and Responsibilities

AHEC-NE Family Practice Clinic, it's physicians, nurses and entire staff are committed to providing you with quality medical care as our patient. It is our policy to respect your individuality and your dignity. We support your right to know about your medical condition and your right to participate in the decisions that affect your well being. For this reason we have adopted the following policy regarding patient rights.  Should we not meet these goals, please let us know. Your comments will be of help to us and to future patients.

Patient Rights

As a patient you have the right to:

Dignity and Respect

1. to be treated with dignity and courtesy; to be given considerate and respectful care at all times and in all circumstances;

2. to treatment for any emergent or urgent medical condition that is likely to deteriorate if such treatment is not given;

3. to impartial medical care regardless of race, creed, gender, national origin, religion/cultural beliefs, sexual preference or financial status;

4. to prompt and reasonable responses to questions and requests;

5. to have any restrictions or communication discussed with you; and

6. to be free from restraints that are not medically necessary;

Confidentiality of Information

1. to privacy and to confidential handling of all communications and records regarding your healthcare; and

2. to have disclosure of your presence at this facility withheld to the extent permitted by law in the event that your safety is in jeopardy by outside persons;

Informed Decisions

1. to a full explanation of diagnosis, proposed treatment, and procedures in terms that are easily understood and that include benefits, risks involved, significant complications, the outcome and alternative treatments available;

2. to an interpreter as necessary to understand all pertinent communication;

3. to review, with your physician, records pertinent to your health care;

4. to have medical information explained or interpreted as necessary;

5. to know at all times the identity and professional status of all individuals providing any type of service and to know what physician is primarily in charge of your care;

6. to know that AHEC-NE Family Practice Clinic is a teaching institution that participates in research protocols, as part of the University of Arkansas for Medical Sciences;

7. to be informed and to give or withhold consent if our facility proposes to engage in or perform research associated with your care or treatment;

8. to expect reasonable continuity of care when appropriate and to be informed of available and realistic patient care options when care at our facility is no longer appropriate;

9. to be informed of our facility’s policies and practices that relate to patient care, treatment and responsibilities, including financial information;

10. to obtain a full explanation of the bills related to your health care services;

11. to request and receive an itemized explanation of the total bill for health services rendered; and

12. to access state and community protective services;

Participation in Care

1. to be involved in decisions about your medical care;

2. to make decisions about the plan of care prior to and during the course of treatment (to the extent permitted by law) and to be informed of the likely medical consequences of those decisions;

3. to refuse treatment;

4. to exclude any or all family members from participating in your care decisions;

5. to have an advanced directive, such as a living will, a health care proxy, or a durable power of attorney for health care;

6. to be involved with family and other decision-makers, in resolving dilemmas about care decisions;

7. to pastoral counseling;

8. to participate in assessment and management of pain; and

9. to express any concerns or grievances orally or in writing without fear of reprisal.

                                                             Patient and Family Responsibilities

As a patient, you or your designees are responsible:

1. for providing accurate information about your present illness and past medical history;

2. for seeking clarification when necessary to fully understand your health problems and proposed plan of action;

3. for following through on agreed plan of care;

4. for following the rules and regulations of the health-care facility, including those pertaining to patient safety;

5. for being considerate of the rights of others; and

6. for providing information for insurance claims and for working with our business office to make payment arrangements when necessary.

To express any concerns with regard to our policies or the service you are receiving, you may speak to your physician, your nurse, or a patient representative.  If you wish to submit a written grievance you may do so addressed to:

AHEC Family Practice Clinic

Quality Management Committee

Attention Committee Chairman

223 East Jackson

Jonesboro, AR  72401

We are committed to addressing your concerns in a timely manner.

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Notice of Privacy Practices

Effective Date:  April 14, 2003

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This Notice is provided on behalf of the University of Arkansas for Medical Sciences including its Medical Center and clinics, Area Health Education Centers, and other facilities (“UAMS”).  UAMS provides patient care through a healthcare system committed to education and research.

PURPOSE: This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information to carry out treatment, payment or healthcare operations and for other purposes permitted or required by law.  “Protected Health Information” is information that may identify the patient and that relates to the patient’s past, present or future physical or mental health, and may include name, address, phone numbers and other identifying information.

We are required to give you this Notice and to maintain the privacy of your Protected Health Information.  We must abide by this Notice, but we reserve the right to change the privacy practices described in it. A current version of this Notice, with required revisions, if any, may be obtained from the UAMS web site, www.uams.edu and will be posted in prominent areas of our facilities.  You may also receive a current copy by sending a written request to the UAMS HIPAA Office, 4301 W. Markham #829, Little Rock, AR  72205.

We understand that medical information about you and your health is personal and confidential, and we are committed to protecting the confidentiality of your medical information.  We create a record of the care and services you receive at UAMS Medical Center and its clinics, Area Health Education Centers and other UAMS facilities.  We need this record to provide services to you and to comply with certain legal requirements.  This Notice will tell you about the ways we may use and disclose your information.  We also describe your rights and certain obligations we have to use and disclose your health information.

If you believe your Privacy Rights have been violated, you may complain to us or to the U.S. Secretary of Health and Human Services.  To file a complaint with us, you may send a letter describing the violation to the UAMS HIPAA Officer, 4301 W. Markham #829, Little Rock, AR 72205.  There will be no retaliation for filing a complaint.

If you have questions or need more information, contact the UAMS HIPAA Officer at 501-614-2187.

WHO WILL FOLLOW THIS NOTICE:  This Notice describes the practices of UAMS healthcare professionals, employees, volunteers and others who work or provide healthcare services at any UAMS facility, including students-in-training.

ACKNOWLEDGMENT:  You will be asked to sign an Acknowledgment of receipt of this Notice.  The delivery of your healthcare services will in no way be conditioned upon the signing of this Acknowledgment.

YOUR PRIVACY RIGHTS

You have the following rights relating to your Protected Health Information and may:

• Obtain a current paper copy of this Notice.

• Inspect or obtain a copy of your records.  Your request to obtain a copy of your medical records must be in writing.  You may be charged a fee for the cost of copying, mailing or other supplies.  We are allowed to deny this request under certain circumstances.  In some situations, you have the right to have the denial of your request reviewed by a licensed healthcare professional identified by UAMS who was not involved in the original denial decision. We will comply with the outcome of this review.

• Request that we amend your record, if you feel the information is incomplete or incorrect.  We are allowed to deny this request in certain circumstances and may ask you to put these requests in writing and provide a reason that supports your request.

• Request in writing a restriction on certain uses and disclosures of your information.  We are not required to agree to the requested restrictions in all circumstances.

• Obtain a record of certain disclosures of your Protected Health Information.

• Make a reasonable request to have confidential communications of your Protected Health Information sent to you by alternative means or at alternative locations.

• We will obtain your written permission for uses and disclosures of your Protected Health Information that are not covered by the Notice or permitted by law.  Except to the extent that the use or disclosure has already occurred, you may cancel this permission.  This request to cancel must be put in writing.

• Submit any written requests to inspect, copy or amend your records to the Medical Records Department.

Our Responsibilities:  We are required to protect the privacy of your Protected Health Information, abide by the terms of the Notice, make the Notice available to you and to notify you if we are unable to agree to a requested restriction or an alternative means of communicating.

Examples of Uses & Disclosures

We will use your Protected Health Information for treatment.  Certain information obtained by a nurse, doctor, or other healthcare worker will be put into your record and used to plan and manage your treatment.  We may provide reports or other information to your doctor or other authorized persons who are involved in your care.

We will use your Protected Health Information for payment.  A bill will be sent to you and/or your insurance company with information about your diagnosis, procedures and supplies used.

We will use your Protected Health Information for regular healthcare operations.  The Medical Staff and other healthcare workers may use your Protected Health Information to check on the care you received, how you responded to it, and for other business purposes related to operating the hospital or clinics.

Business Associates:  We may share some of your Protected Health Information with outside people or companies who provide services for us, such as typing physician reports.

Patient Directory:  Unless you tell us not to, we may use and disclose your name, location in the facility, and general condition to people who ask for you by name.  If provided by you, your religious affiliation will only be given to members of the clergy.

Notification:  We may use or disclose your Protected Health Information to notify a family member or other person involved in your care, your location and general condition unless you tell us not to do so.

Communication with family: We may share your Protected Health Information with a family member, a close personal friend, or a person that you identify, if we determine they are involved in your care or in payment for your care, unless you tell us not to do so.

Research:  Your Protected Health Information may be used for research purposes in certain circumstances with your permission, or after we receive approval from a special review board whose members review and approve the research project.

Coroners, Medical Examiners, Funeral Directors:  We may disclose your Protected Health Information to these people, to the extent allowed by law, so that they may carry out their duties.

Organ Donor Organizations: We may share your Protected Health Information with the organ donation agency for the purpose of tissue or organ donation in certain circumstances and as required by law.

Contacts:  We may contact you to provide appointment reminders or to tell you about new treatments or services.

Fundraising and Marketing:  We may contact you as part of any fundraising or marketing efforts.

Food and Drug Administration (FDA): We may share your Protected Health Information with certain government agencies like the FDA so they can recall drugs or equipment.

Workers Compensation: We may disclose your Protected Health Information for workers' compensation claims.

Public Health: We may give your Protected Health Information to public health agencies who are charged with preventing or controlling disease, injury or disability and as required by law 

Communicable Disease: We may disclose your Protected Health Information to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition, if authorized by law to do so, such as a disease requiring isolation.

Correctional Institution: If you are an inmate of a correctional institution, we may disclose your Protected Health Information needed for your health or the health and safety of others.

Law Enforcement: We must disclose your Protected Health Information for law enforcement purposes as required by law.

As Required by Law: We must disclose your Protected Health Information when required by federal, state or local law.

Health Oversight:  We must disclose your Protected Health Information to a health oversight agency for activities authorized by law, such as investigations and inspections. Oversight agencies are those that oversee the healthcare system, government benefit programs, such as Medicaid, and other government regulatory programs.

Abuse or Neglect: We must disclose your Protected Health Information to government authorities that are authorized by law to receive reports of suspected abuse or neglect.

Legal Proceedings: We may disclose your Protected Health Information in the course of any judicial or administrative proceeding or in response to a court order, subpoena, discovery request or other lawful process.

Required Uses and Disclosures: We must make disclosures when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the HIPAA Privacy Regulations.

To Avoid Harm:  We may use and disclose information about you when necessary to prevent a serious threat to your health or safety of the health or safety of the public or another person.

For Specific Government Functions:  In certain situations, we may disclose Protected Health Information of military personnel and veterans.  We may disclose your Protected Health Information for national security activities required by law.

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Privacy Statement